The aim of the book is to describe tested microsurgical procedures of kidney, pancreas, islets, heat, liver and small bowel transplantation. All procedures written in the book are used in our experimental research laboratory and their description will be provided by an experienced researcher. The book is organized into ‘General’ and ‘Specific’ sections. The ‘General’ section will include principles, doses and available drugs for rat anaesthesia, the surgical anatomy of the rat, a brief review of immunosuppressant’s used in rat models, a description of basic surgical techniques and blood sampling. The ‘Specific’ section will include a description of the rat model with the appropriate organ failure relevant to the organ transplantation, which will be followed by a detailed description of the surgical procedure with high quality pictures of key steps. Each chapter will describe ‘tips and tricks’ including practical advice and recommendations.
Preclinical experimental transplantation research that is based on microsurgical models in rats fulfills two indispensable conditions for modern organ transplanta tion research: Almost all organ grafts can be performed on the rat with an amount of technical effort that is still justifiable. Thus transplantation models that are analogous to human organ transplantation can be developed, tested, and evaluated. This fulfills a necessary condition from the standpoint of surgery. With the species rat, we have a great variety of genetically different inbred strains. From the immunological point of view this is an indispensable prerequisite for the investigation of preclinical transplantation models that can be expected to produce controllable, reproducible results. In vivo experimental results can be supplemented by and correlated to in vitro tests. Lately these experimental results are being greatly expanded and more precisely defined by the application of immunohistological methods that have been established recently in Kiel. In this book we hope to present a cross section of the microsurgical models in use today and of current immunological and immunohistological models. Furthermore, we wish to record the present state of microsurgical organ transplantation research and to show its relationship to the current state and development of clinical organ transplantation. A special aspect of our Kiel research group is the long-term, well-functioning, interdisciplinary cooperation between surgery, immunology, and pathology. Through this cooperation we attempt to provide an atmosphere in which theoretical and practical viewpoints can mutually influence each other.
It is like a fairy story! Or at least a beautiful epic, a truly significant page in the history of medicine, a staggering scene in which several actors come into play, both fundamentalists and clinical practitioners, eager to place all these new developments at the disposal of those suffering from ill health. Everyone is passionate about their work, be it providing new knowledge or perfecting new therapeutic methods. Man has always been fascinated by the possibility of replacing a damaged organ with a healthy one. Several attempts have been made over the centuries, and some miracles have been reported, such as those of Saint Damien and Saint Come as illustrated by Fra Angelico. The modern saga, however, started more modestly on the mouse. It is on the mouse that the first tissue group was discovered; yet the study of human tissue groups could only be carried out on a human. One human must be subjected to the thousands of tests that have enabled us to unravel the extraordinary complexity of the HLA system.
Although pancreas transplants have been performed for more than 30 years, the last few years have witnessed significant growth in the options available for pancreas transplantation as well as subtantial improvements in outcome. It is therefore appropriate that a new text summarize the recent advances and put forth the standard of future care. Transplantation of the Pancreas, edited by Drs. Gruessner and Sutherland fulfills this mission by providing a state-of-the-art, definitive reference work on pancreas transplantation for transplant surgeons and physicians as well as for endocrinologists, diabetologists, nephrologists, and neurologist. The editors, from the renowned University of Minnesota Transplant Division and the Diabetes Institute, have assembled a group of renowned experts to provide an all inclusive overview of pancreas transplantation. The text features insights on the pathophysiology of diabetes mellitus and the limitations of nontransplant treatments, highlights experimental research and clinical history of pancreas transplantation, and compares and contrasts different surgical procedures. The discussions detail the broad spectrum of posttransplant complications and their treatments, which frequently require skills in general, vascular, and laparoscopic surgery, interventional radiology, critical care, and infectious disease. Chapters on immunosuppression, immunology, pathology, long-term outcome, quality of life, and cost-effectiveness focus on issues unique to pancreas recipients. Evolving areas, such as pretransplant evaluation of pancreas transplant candidates, living donation, and the current status of islet transplantation are discussed. Augmented by more than 280 illustrations, including full color line drawings created exclusively for the text, this book is the standard reference for all transplant professionals as well as all physicians caring for diabetic patients.
This supplement to Transplant International contains the Proceedings of the successful 5th Congress of the European Society for Organ Transplantation held in Maastricht from 7-10 October 1991. Of 827 abstracts submitted to the congress, 548 were selected by the Scien tific Committee for either oral or poster presentation. Of these 548 presenta tions, the guest editors selected 212 full papers for publication in this book. Two aspects are important where proceedings are concerned-the quality of the papers and the speed of publication. I thank our authors and guest editors, whose combined expertise has given us a guarantee of quality. I also thank our editorial and production teams for their tremendous efforts to hasten editing, proofreading, printing, and publication. In particular, I would like to express my gratitude to Maurits Booster, M.D., and Sylvia van Roosmalen for their assist ance and support in seeing this supplement through to completion. As a concession to time, we have waived some of our stringent rules of style and limited our correspondence with authors by, for example, page proofs being reviewed and corrected in house only. This enables us to publish two months earlier but has the disadvantage that, given the allotted time, we have not been able to ensure that each and every article has an abstract, nor that every "i" has been dotted in the reference lists or in the addresses/institute affiliations of all the authors.
R. Y.Calne Surgeons are transplanting kidneys in ever increasing numbers-more than 10000 renal allografts have now been reported to the Transplant Registry. With related donors 75% of grafted kidneys continued to function after 2 years, compared with 50% when the donors were unrelated. The therapeutic value is obvious, but the management is largely empirical and results have improved little in the past 5 years. The basic sciences related to tissue transplantation have advanced rapidly. New serological and tissue culture techniques and chemical analysis of antigens and anti bodies have produced complicated data that is almost incomprehensible to the non specialist. Mathematical treatment of genetic probabilities and of immunological kinetics are similarly difficult to follow for those not especially trained. There has always been a gulf between the practical clinician whose patients do not behave like inbred rodents and the biologist who likes carefully controlled experiments with easily observed results. Both realize, however, that predictable and safe control of rejection must involve close collaboration and co-operation between the laboratory and the clinic. Unfortwlately, the different nature of the work and the workers has widened the gap between them. The clinicians tend to improve their techniques and patient care, whilst the biologists seek clearer and more precisely deflned experi ments which lead them to use increasingly artiflcial experimental models.
First Published in 1988, Experimental Liver Transplantation is a helpful guide through the process of Liver Transplantation and how the surgical techniques have evolved over the years. Filled with references to the history of Liver transplantation, to the experimental procedures performed on rats. This is an essential guide to any students of surgery or professionals in their respective fields.